There is an extensive published literature reporting the use of adhesives, Sealants, and topical hemostatics in surgery. There is little doubt that the hemostatic effects of these devices produce a beneficial impact on blood loss. However, there is a wide variation in the literature results. Most of the initial clinical data were obtained in cardiovascular surgery. The only trial that has provided the most significant data in hemostatic efficacy was published by Rousou et al in J Thorac Cardiol South 1999. In this randomized multicenter study, 333 patients that underwent emergency cardiac reoperations were randomized to receive either conventional treatment with fibrinogen or other hemostatic. The 92% of the patients assigned to receive fibrin sealant had a complete hemostasis at 5 minutes, compared with the 12% of those treated with other topical hemostatic.